A first-term congressman who spent three decades as a physician — and is now part of a group of Republican doctors who have a major role in replacing Obamacare — is facing backlash after saying that poor people "just don't want health care and aren't going to take care of themselves."
Rep. Roger Marshall, R-Kan., a member of the GOP Doctors Caucus, said comments he made to Stat News were not meant to suggest that poor people take health care for granted. The comments were published in a story last week about his burgeoning role in the fight to replace the Affordable Care Act.
"Just like Jesus said, 'The poor will always be with us,'" Marshall said in response to a question about Medicaid, which expanded under Obamacare to more than 30 states. "There is a group of people that just don't want health care and aren't going to take care of themselves."
He added that "morally, spiritually, socially," the poor, including the homeless, "just don't want health care."
"The Medicaid population, which is a free credit card as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I'm not judging; I'm just saying socially that's where they are," he told Stat News, a website focused on health care coverage. "So there's a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought the ER."
The comments immediately drew criticism from Medicaid advocates in Kansas, with some saying that Marshall mischaracterized and misunderstood people who are on the program.
"These are people who are out there, working hard, paying their bills, and to have their elected member of Congress pointing their finger at them I'm sure is disappointing," David Jordan, executive director of the Alliance for a Healthy Kansas, told the Kansas City Star.
In response to the backlash, Marshall, who was elected in November, said he was trying to explain that a national health care policy around "one segment of the population" does not work because groups of people have varying medical needs and use different health care resources.
"I was also saying that Obamacare has increased premiums on working, middle-class families by almost 200 percent in some places, and with deductibles of over $10,000, many don't actually have access to health care," Marshall said in a statement. "Coverage means nothing if you can't afford access."
He added: "When I said, 'the poor will always be with us,' it was actually in the context of supporting the obligation we have to always take care of people, but we cannot completely craft a larger, affordable health care policy around a comparatively small segment of the population who will get care no matter what."
He also brought up his years in the medical field. Before he was elected, Marshall was an OB/GYN in Great Bend, Kansas, helping to deliver more than 5,000 babies throughout his career, according to a brief biography.
"Many patients drove over a hundred miles to see us as I was the only OB clinic to accept Medicaid, and others who could not afford prenatal care. My career gives testimony to my personal watchfulness to those who need help, and to allude otherwise is simply not judicious," Marshall said in his statement. "I am a physician, not a politician. While I don't perfectly rehearse talking points, my agenda is driven my two realities: That Obamacare has been detrimental to patients and that we must care for all in need, no matter what."
The political newcomer unseated former Rep. Tim Huelskamp to represent the 1st Congressional District of Kansas. He's a new member of the GOP Doctors Caucus, co-chaired by Rep. Phil Roe, R-Tenn., one of the leading ergative voices in the health care debate. Health and Human Services Secretary Tom Price, who was confirmed last month, is a former member of the caucus.
Marshall is not the only House member who's had to clarify his comments about health care and the poor.
"Americans have choices, and they've got to make a choice," Rep. Jason Chaffetz, R-Utah, said on CNN Tuesday morning. "And so maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest in their own health care."
Later that day, Chaffetz was on Fox News clarifying his remarks. "Maybe I didn't say it as smoothly as I possibly could, but people need to make a conscious choice," he said. "I believe in self-reliance, and they're going to have to make those decisions. We want people to have access to an affordable health care product."
A new health care bill unveiled by Republicans as a replacement for Obamacare is now making its way through Congress. The American Health Care Act replaces federal insurance subsidies with individual tax credits and grants to help states shape their own policies. It also preserves two of the most popular features of the ACA: Allowing young adults to stay on their parents' insurance until they're 26 and forbidding insurers from denying coverage to people with preexisting conditions.
After 18 hours of debate, the bill passed 23 to 16 in the House Ways and Means Committee before dawn on Thursday.
The Washington Post's Amy Goldstein, Elise Vieback, Sean Sullivan, Mike DeBonis and Kelsey Snell contributed to this story.